| Prophylactic treatment after myocardial infarction in primary care: how far can we go? | |
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MedLine Citation:
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PMID: 12509367 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Despite best practice, it may not be achievable in some patients to reach the optimal goals of secondary prevention recommendations for various reasons, such as co-morbidity, contraindications for some drugs or side effects. OBJECTIVE: Our aim was to estimate the achievable standards for audit purposes in primary care for prophylactic treatment of secondary prevention of myocardial infarction. METHODS: We conducted a survey of consecutive patients with a hospital diagnosis of first acute myocardial infarction during 1997 who were identified from discharge books from four hospitals and interviewed at their primary health centre 2 years after admission. The achievable standard for a prophylactic drug was then defined as the proportion of patients that could benefit from the treatment excluding those that for one justified reason or another were off medication. RESULTS: Three hundred and sixty-nine patients were interviewed in the follow-up. Aspirin or another antiplatelet regimen was prescribed in 86.9 patients, beta-blockers in 50.2%, angiotensin-converting enzyme (ACE) inhibitors in 32.5% and lipid-lowering drugs in 52%. The estimated achievable standards for those prescribed drugs were 94.5, 71,8, 50.5 and 69.8%, respectively. CONCLUSIONS: There is an underuse of prophylactic drug therapies after myocardial infarction. The standards established in this study for secondary preventive drug treatment might be achieved through a reasonable effort by GPs working in primary care committed to improving the quality of care. |
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Authors:
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Carlos Brotons; Gaietà Permanyer; Valeria Pacheco; Irene Moral; Aida Ribera; Purificación Cascant; Josep Pinar; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Family practice Volume: 20 ISSN: 0263-2136 ISO Abbreviation: Fam Pract Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-01-01 Completed Date: 2003-05-01 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8500875 Medline TA: Fam Pract Country: England |
Other Details:
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Languages: eng Pagination: 32-5 Citation Subset: IM |
Affiliation:
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Unit of Clinical Epidemiology and Hospital/Primary Care Research Unit-Cardiology Department, Hospital General Universitari Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035 Barcelona, Spain. cbrotons@eapsardenya.net |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Drug Utilization* Female Guideline Adherence Humans Male Medical Audit Middle Aged Myocardial Infarction / drug therapy*, epidemiology, prevention & control* Physician's Practice Patterns* Practice Guidelines as Topic Primary Health Care / standards* Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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